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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT02557711
Other study ID # CMRPG8D0951
Secondary ID
Status Not yet recruiting
Phase N/A
First received September 17, 2015
Last updated March 28, 2016
Start date June 2016
Est. completion date September 2017

Study information

Verified date March 2016
Source Chang Gung Memorial Hospital
Contact Pong Ya-Ping, MD
Phone 889-7-7317123
Email yaping0707@gmail.com
Is FDA regulated No
Health authority Taiwan : Food and Drug Administration
Study type Observational

Clinical Trial Summary

The aim of this study: 1. To evaluate the correlation between the clinic tools and ultrasound elastography/ ARFI imaging in stroke patients. 2. To assess the reliability of elastography/ ARFI imaging in spasticity evaluation of stroke patients.


Description:

Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) are the most commonly used tools for spasticity assessment. But these clinic methods cannot reveal the architecture and stiffness of muscles. In recent years, ultrasound elastography and acoustic radiation force impulse (ARFI) are used in musculoskeletal disorders, including spasticity. There are no studies about the correlation between spasticity and ultrasound elastography /ARFI imaging in stroke patients. The investigators will enroll 50 stroke patients with hemiplegia and biceps brachii muscle spasticity. One physical therapist will measure MAS and MTS for spasticity of biceps brachii muscle. Two physiatrists will perform ultrasound elastography and ARFI for intra-rater and inter-rater reliability evaluation. The evaluations of B-mode ultrasound, elastography and ARFI included Heckmatt scale, biceps brachii ratio, strain ratio, dynamic sonoelastography score, color intensity, and shear wave velocity. After performing all assessments, the investigators will analyze the correlation between the clinic tools and elastography/ ARFI imaging and evaluate the reliability of elastography/ ARFI imaging in spasticity evaluation.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 50
Est. completion date September 2017
Est. primary completion date May 2017
Accepts healthy volunteers No
Gender Both
Age group N/A and older
Eligibility Inclusion Criteria:

- stroke patients with hemiplegia and biceps brachii muscle spasticity.

Exclusion Criteria:

- elbow joint contracture deformity

- combined other neuromuscular system disease

- affected upper extremity has local infection

- patient who can't follow instruction, who is restlessness and whose elbow can't meet the positioning criteria

Study Design

Observational Model: Case-Only, Time Perspective: Cross-Sectional


Related Conditions & MeSH terms


Intervention

Device:
ultrasound elastography, acoustic radiation force impulse
Two physiatrists will perform ultrasound elastography and ARFI for intra-rater and inter-rater reliability evaluation.

Locations

Country Name City State
Taiwan Chang Gung Memorial Hospital Kaohsiung

Sponsors (1)

Lead Sponsor Collaborator
Chang Gung Memorial Hospital

Country where clinical trial is conducted

Taiwan, 

References & Publications (29)

Alhusaini AA, Dean CM, Crosbie J, Shepherd RB, Lewis J. Evaluation of spasticity in children with cerebral palsy using Ashworth and Tardieu Scales compared with laboratory measures. J Child Neurol. 2010 Oct;25(10):1242-7. doi: 10.1177/0883073810362266. Epub 2010 Mar 10. — View Citation

Ansari NN, Naghdi S, Arab TK, Jalaie S. The interrater and intrarater reliability of the Modified Ashworth Scale in the assessment of muscle spasticity: limb and muscle group effect. NeuroRehabilitation. 2008;23(3):231-7. — View Citation

Ansari NN, Naghdi S, Hasson S, Azarsa MH, Azarnia S. The Modified Tardieu Scale for the measurement of elbow flexor spasticity in adult patients with hemiplegia. Brain Inj. 2008 Dec;22(13-14):1007-12. doi: 10.1080/02699050802530557. — View Citation

Ansari NN, Naghdi S, Hasson S, Mousakhani A, Nouriyan A, Omidvar Z. Inter-rater reliability of the Modified Modified Ashworth Scale as a clinical tool in measurements of post-stroke elbow flexor spasticity. NeuroRehabilitation. 2009;24(3):225-9. doi: 10.3233/NRE-2009-0472. — View Citation

Ansari NN, Naghdi S, Moammeri H, Jalaie S. Ashworth Scales are unreliable for the assessment of muscle spasticity. Physiother Theory Pract. 2006 Jun;22(3):119-25. — View Citation

Bai M, Du L, Gu J, Li F, Jia X. Virtual touch tissue quantification using acoustic radiation force impulse technology: initial clinical experience with solid breast masses. J Ultrasound Med. 2012 Feb;31(2):289-94. — View Citation

Bhatia KS, Rasalkar DD, Lee YP, Wong KT, King AD, Yuen HY, Ahuja AT. Evaluation of real-time qualitative sonoelastography of focal lesions in the parotid and submandibular glands: applications and limitations. Eur Radiol. 2010 Aug;20(8):1958-64. doi: 10.1007/s00330-010-1756-0. Epub 2010 Apr 21. — View Citation

Blackburn M, van Vliet P, Mockett SP. Reliability of measurements obtained with the modified Ashworth scale in the lower extremities of people with stroke. Phys Ther. 2002 Jan;82(1):25-34. — View Citation

Botar-Jid C, Damian L, Dudea SM, Vasilescu D, Rednic S, Badea R. The contribution of ultrasonography and sonoelastography in assessment of myositis. Med Ultrason. 2010 Jun;12(2):120-6. — View Citation

Buck AR, Verstraete N, Li Y, Schweizer A, Snedeker JG, Buck FM. Detection of small tendon lesions by sonoelastographic visualization of strain profile differences: initial experiences. Skeletal Radiol. 2012 Sep;41(9):1073-9. doi: 10.1007/s00256-011-1349-2. Epub 2012 Jan 5. — View Citation

Friedrich-Rust M, Romenski O, Meyer G, Dauth N, Holzer K, Grünwald F, Kriener S, Herrmann E, Zeuzem S, Bojunga J. Acoustic Radiation Force Impulse-Imaging for the evaluation of the thyroid gland: a limited patient feasibility study. Ultrasonics. 2012 Jan;52(1):69-74. doi: 10.1016/j.ultras.2011.06.012. Epub 2011 Jul 7. — View Citation

Fuchs D, Hausen A, Hoefler E, Schönitzer D, Werner ER, Dierich MP, Hengster P, Reibnegger G, Schulz T, Wachter H. Activated T cells in addition to LAV/HTLV-III infection: a necessary precondition for development of AIDS. Cancer Detect Prev Suppl. 1987;1:583-7. — View Citation

Goycoolea HG, Goycoolea MV, Farfan CR. Racial and familial factors in otitis media. A point prevalence study on Easter Island. Arch Otolaryngol Head Neck Surg. 1988 Feb;114(2):147-9. — View Citation

Kang J, Kwon H, Cho J, Oh J, Nam K, Yoon S, Kang M, Lee S, Han S. Comparative study of shear wave velocities using acoustic radiation force impulse technology in hepatocellular carcinoma: the extent of radiofrequency ablation. Gut Liver. 2012 Jul;6(3):362-7. doi: 10.5009/gnl.2012.6.3.362. Epub 2012 May 2. — View Citation

Kaya T, Karatepe AG, Gunaydin R, Koc A, Altundal Ercan U. Inter-rater reliability of the Modified Ashworth Scale and modified Modified Ashworth Scale in assessing poststroke elbow flexor spasticity. Int J Rehabil Res. 2011 Mar;34(1):59-64. doi: 10.1097/MRR.0b013e32833d6cdf. — View Citation

Mackey AH, Walt SE, Lobb G, Stott NS. Intraobserver reliability of the modified Tardieu scale in the upper limb of children with hemiplegia. Dev Med Child Neurol. 2004 Apr;46(4):267-72. — View Citation

Mehrholz J, Wagner K, Meissner D, Grundmann K, Zange C, Koch R, Pohl M. Reliability of the Modified Tardieu Scale and the Modified Ashworth Scale in adult patients with severe brain injury: a comparison study. Clin Rehabil. 2005 Oct;19(7):751-9. — View Citation

Nightingale K, Soo MS, Nightingale R, Trahey G. Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility. Ultrasound Med Biol. 2002 Feb;28(2):227-35. — View Citation

Niitsu M, Michizaki A, Endo A, Takei H, Yanagisawa O. Muscle hardness measurement by using ultrasound elastography: a feasibility study. Acta Radiol. 2011 Feb 1;52(1):99-105. doi: 10.1258/ar.2010.100190. — View Citation

Park GY, Kwon DR. Sonoelastographic evaluation of medial gastrocnemius muscles intrinsic stiffness after rehabilitation therapy with botulinum toxin a injection in spastic cerebral palsy. Arch Phys Med Rehabil. 2012 Nov;93(11):2085-9. doi: 10.1016/j.apmr.2012.06.024. Epub 2012 Jul 7. — View Citation

Picelli A, Bonetti P, Fontana C, Barausse M, Dambruoso F, Gajofatto F, Girardi P, Manca M, Gimigliano R, Smania N. Is spastic muscle echo intensity related to the response to botulinum toxin type A in patients with stroke? A cohort study. Arch Phys Med Rehabil. 2012 Jul;93(7):1253-8. doi: 10.1016/j.apmr.2012.02.005. Epub 2012 Apr 12. — View Citation

Pierani A, Heguy A, Fujii H, Roeder RG. Activation of octamer-containing promoters by either octamer-binding transcription factor 1 (OTF-1) or OTF-2 and requirement of an additional B-cell-specific component for optimal transcription of immunoglobulin promoters. Mol Cell Biol. 1990 Dec;10(12):6204-15. — View Citation

Pillen S, van Keimpema M, Nievelstein RA, Verrips A, van Kruijsbergen-Raijmann W, Zwarts MJ. Skeletal muscle ultrasonography: Visual versus quantitative evaluation. Ultrasound Med Biol. 2006 Sep;32(9):1315-21. — View Citation

Sconfienza LM, Silvestri E, Orlandi D, Fabbro E, Ferrero G, Martini C, Sardanelli F, Cimmino MA. Real-time sonoelastography of the plantar fascia: comparison between patients with plantar fasciitis and healthy control subjects. Radiology. 2013 Apr;267(1):195-200. doi: 10.1148/radiol.12120969. Epub 2013 Jan 7. — View Citation

Tudisco C, Bisicchia S, Stefanini M, Antonicoli M, Masala S, Simonetti G. Tendon quality in small unilateral supraspinatus tendon tears. Real-time sonoelastography correlates with clinical findings. Knee Surg Sports Traumatol Arthrosc. 2015 Feb;23(2):393-8. doi: 10.1007/s00167-013-2551-7. Epub 2013 Jun 16. — View Citation

van Wijck FM, Pandyan AD, Johnson GR, Barnes MP. Assessing motor deficits in neurological rehabilitation: patterns of instrument usage. Neurorehabil Neural Repair. 2001;15(1):23-30. — View Citation

Vasilescu D, Vasilescu D, Dudea S, Botar-Jid C, Sfrângeu S, Cosma D. Sonoelastography contribution in cerebral palsy spasticity treatment assessment, preliminary report: a systematic review of the literature apropos of seven patients. Med Ultrason. 2010 Dec;12(4):306-10. Review. — View Citation

Wu CH, Chang KV, Mio S, Chen WS, Wang TG. Sonoelastography of the plantar fascia. Radiology. 2011 May;259(2):502-7. doi: 10.1148/radiol.11101665. Epub 2011 Feb 25. — View Citation

Yanagisawa O, Niitsu M, Kurihara T, Fukubayashi T. Evaluation of human muscle hardness after dynamic exercise with ultrasound real-time tissue elastography: a feasibility study. Clin Radiol. 2011 Sep;66(9):815-9. doi: 10.1016/j.crad.2011.03.012. Epub 2011 May 6. — View Citation

* Note: There are 29 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS) patients will be evaluated within 1 month after basic history taking and consent signing No
Secondary the thickness of biceps brachii patients will be evaluated within 1 month after basic history taking and signing consent No
Secondary Heckmatt scale patients will be evaluated within 1 month after finishing history taking and consent signing No
Secondary strain ratio patients will be evaluated within 1 month after finishing history taking and consent signing No
Secondary Dynamic Sonoelastography Score(DS score) patients will be evaluated within 1 month after finishing history taking and consent signing No
Secondary The mean values of the intensity of red, green, and blue on histogram of bicep brachii patients will be evaluated within 1 month after finishing history taking and consent signing No
Secondary shear wave velocity within region of interest between biceps brachii and brachialis patients will be evaluated within 1 month after finishing history taking and consent signing No
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